"Fixator-assisted Nailing" Technique for Closed Segmental Tibia Shaft Fracture with Extensive Soft Tissue Injury - A...

Area of Science:

• Orthopedic Surgery
• Trauma Management

Background:

• Segmental tibia fractures with extensive soft tissue injuries are rare and present significant surgical challenges.
• Current treatment strategies for such complex fractures are not definitive.

Observation:

• A 52-year-old male sustained a closed segmental tibia and fibula fracture with extensive skin blistering from a road traffic accident.
• A monoplanar external fixator was applied within 24 hours due to the severe soft tissue injury.
• After 3 weeks, with improved skin condition, closed intramedullary multi-locking nailing was performed using the external fixator for reduction.

Findings:

• The fracture healed completely at 15 months.
• The patient achieved an excellent functional outcome with full knee range of motion at 2-year follow-up.
• No complications were reported during the follow-up period.

Implications:

• Fixator-assisted nailing is a simple, minimally invasive technique for complex tibia fractures.
• This method aids in fracture reduction, prevents axial rotation, and preserves periosteal blood supply.
• Temporary external fixation is crucial for soft tissue healing, enabling subsequent internal fixation.